An unexpected change
in training plans
Patient asleep, face mask in my right hand with my left squeezing the bag, my phone vibrates in my
pocket and I get a horrible sinking feeling. A few weeks earlier, I had attended hospital with my wife
with a referral for an abdominal mass. Initially we weren’t worried - she was eight months post-partum
and we thought it was just things settling down. But the call was from her and confirmed my sinking
feeling. ‘Something’ had been found – one of many lymph nodes turned out to be non-Hodgkin’s
lymphoma. I left theatre to find my college tutor, and did not return to work for seven months.
It is not common for a young family to be hit by cancer [1], and
so I hope to shed light for anyone in a similar position on ways to
continue with work and training. After the fateful call, my college
tutor referred me to an Occupational Health consultant who
helped me make the decision to pause training. I was advised to
use an out-of-programme career break (OOP-C) while I assumed
caring responsibilities for my family, and to return to work less-than-full-time when I was ready. Knowing I could step out of
training, with the possibility of return, was a huge relief.
Over the next seven months, while my wife had chemotherapy
I was able to be at home to support her and look after our son.
Navigating the turbulence of the treatment cycles was challenging,
but the following helped:
- Planning a routine and keeping to it. We focused on
building structure into our day, including activities for our
son.
- Exercising every day, even for a short walk.
- Healthy eating.
- Looking after our mental health – we took time out each day
for ourselves. I would bike, run or meet friends and my
wife might visit the Maggie’s Centre. We found it helpful to
talk, sharing the rough and the smooth, and never passed
up an opportunity to be cooked for!
- Blogging – sharing our story on Instagram connected
us with a wide community of people going through similar
experiences.
- Apps – Calm and Headspace helped us get started with
mindfulness.
We had support from family and friends as well as professionals,
including a haematology psychologist and our GP who offered
drop-in carer clinics. My educational supervisor checked in
monthly, whilst my college tutor managed the logistical changes
to my training. I completed forms for these meetings on the RCoA
Lifelong Learning platform which I then used for reflection, and was
able to complete an ARCP.
Seven months later we were elated when my wife’s follow-up
scan showed no evidence of disease and, with the support of my
department and Occupational Health, I was signed off as fit-for-work
and returned to training. I took a phased return, working up
from 60% less-than-full-time to 80%.
My experience has given me a fresh perspective on wellbeing and
more respect for work-life balance. Becoming more mindful of my
mental health has helped me to identify and mitigate potentially stressful triggers, including when I was assigned to work in ICU in
the hospital where my wife was treated and where haematology
patients are admitted. Recognising this prompted difficult feelings,
as I knew I wasn’t ready; I told my supervisors who moved me.
Feeling stronger, I’ve since been back and enjoyed a positive
experience.
To sustain myself as a good husband, father and anaesthetist, I’ve
learned I must look after myself. Avoiding stress, spending time
with friends and family, and minimising burnout have become new
priorities.
There are approximately 2500 new cancer cases in young adults
every year and rates are rising [1]. Medics are not immune, and we
may find ourselves or colleagues in difficult circumstances. This is
not the time to think that being a doctor automatically means you
will cope; it is time to seek help.
Gaurav Purwaha
Anaesthesia and Critical Care Senior Fellow
Nottingham City Hospitals
References
- Cancer Research UK. Young people’s cancers incidence,
2021. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/young-peoples-cancers#heading-Zero (accessed 28/6/2021).